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目的了解医院感染的鲍氏不动杆菌分布及耐药性变化,为合理使用抗菌药物和医院感染的预防控制提供相关科学依据。方法回顾性分析医院2007-2012年分离的鲍氏不动杆菌标本来源及临床分布,以K-B纸片扩散法检验其耐药性,观察鲍氏不动杆菌耐药性的变化。结果医院感染鲍氏不动杆菌标本来源以痰液为主,占88.6%;主要分布在ICU占29.17%、儿科占16.41%、神经外科占13.38%和呼吸内科占12.15%;2010年前医院鲍氏不动杆菌分离率总体呈上升趋势,2010年出现明显回落,之后其分离率波动不明显;鲍氏不动杆菌对所试验抗菌药物具有较高耐药率,对哌拉西林、氨曲南耐药率上升趋势明显,2010年其对全部药物的耐药率>50.0%,2010年后鲍氏不动杆菌耐药上升趋势有所遏制。结论 ICU是医院感染鲍氏不动杆菌的主要科室之一,抗菌药物的规范应用结合医院感染预防控制措施的落实,有利于减少耐药菌株的产生,控制耐药菌株的传播及流行,从而有效遏止鲍氏不动杆菌多药耐药的发展。
Objective To understand the distribution and drug resistance of Acinetobacter baumannii infection in hospitals and to provide relevant scientific evidences for the rational use of antimicrobial drugs and prevention and control of nosocomial infections. Methods The source and clinical distribution of Acinetobacter baumannii isolated in the hospital from 2007 to 2012 were retrospectively analyzed. The drug resistance of Acinetobacter baumannii was observed by K-B disk diffusion method and the changes of drug resistance of Acinetobacter baumannii were observed. Results The main source of nosocomial Acinetobacter baumannii was sputum, accounting for 88.6%. The main distribution was 29.17% in ICU, 16.41% in pediatrics, 13.38% in neurosurgery and 12.15% in respiratory medicine. Before 2010, Acinetobacter spp isolates generally showed an upward trend in 2010 showed a significant decline after the separation rate was not obvious fluctuations; Acinetobacter baumannii on the tested antimicrobial drugs have a higher resistance rate of piperacillin, aztreonam Drug resistance rate increased significantly in 2010, its resistance to all drugs> 50.0%, after 2010, the rise of Acinetobacter baumanii resistance has been checked. Conclusion ICU is one of the main departments of hospital infection with Acinetobacter baumannii. The standardized application of antimicrobial agents in combination with the prevention and control measures of nosocomial infection is beneficial to reduce the generation of drug-resistant strains and control the spread and prevalence of drug-resistant strains so as to be effective Stop the development of multi-drug resistant Acinetobacter baumannii.